Tuesday, June 6, 2017

Medicare Enrollment Periods

By Lara Anderson

Initial, general, open, special—Medicare enrollment periods can be confusing. Let’s take the guesswork out of these important dates and provide better understanding of their importance. Mark your calendar and plan ahead to help prevent a lapse in health coverage as well as costly penalties.

Initial Enrollment Period (the seven months surrounding your 65th birthday)
You can enroll in Original Medicare (Parts A and B), Medicare Advantage (Part C) and Part D during your Initial Enrollment Period.

Your Initial Enrollment Period is unique to you and your birthday. It is a seven-month period that begins three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65. Be sure to sign up early in the seven-month period to avoid delays in coverage.

Special Enrollment Period (if you are covered under a large group employee policy, or other special circumstances)
In certain circumstances, you can enroll in Original Medicare (Parts A and B), Medicare Advantage (Part C) and Part D during a Special Enrollment Period.

A Special Enrollment Period is a window of time to apply for Part A and/or Part B without incurring late penalties after the Initial Enrollment Period has expired. If your employer has 20 or more employees, and you are covered under your employer’s group health plan, you may choose to postpone signing up for Part A (if you have to buy it) or Part B when you first become eligible. A Special Enrollment Period allows you to sign up for Part A and/or Part B anytime you’re still covered by the group plan or during the eight-month period that starts the month after employment ends or the coverage ends, whichever happens first. It is important to note that COBRA, retiree health plans, and individual health coverage are not considered coverage based on current employment. Therefore, you are not eligible for a Special Enrollment Period when that coverage ends.

You may also qualify for special enrollment if:
·        You move.
·        You’re eligible for Medicaid.
·        You qualify for the Extra Help program for Medicare prescription drug costs.
·        You’re getting care in an institution, like a skilled nursing facility or long‑term care hospital.
·       See more special circumstances here.

General Enrollment Period (if you are signing up late)
You can enroll in Original Medicare (Parts A and B) during your General Enrollment Period. If you already have Part A and enroll in Part B during this period, you can also enroll in Medicare Advantage (Part C) and Part D plans at this time.

If you didn’t sign up for Part A and/or Part B and Part D during your Initial Enrollment Period, and you don’t qualify for a Special Enrollment Period, you can sign up during the annual General Enrollment Period. These dates are January 1 – March 31. Your coverage won’t start until July 1 of that year, and you may have to pay higher premiums for late enrollment.

Open Enrollment Period (if you want to change plans)
You can enroll in or change Medicare Advantage (Part C) and Part D during the Open Enrollment Period.

This may be the only opportunity to change your Medicare health or prescription drug coverage for the upcoming year. October 15 – December 7 marks the dates for Open Enrollment, with coverage beginning January 1 of the following year. Medicare health plans and prescription drug plans can make changes each year, so it is important to review materials the plan sends you to be sure it meets your anticipated needs for the following year.

Medigap Open Enrollment Period (avoid being denied coverage)
Your Medigap Open Enrollment Period is the best time to buy a Medigap policy. This six-month period begins on the first day of the month in which you are enrolled in Part B (Some states have additional Open Enrollment Periods). After this enrollment period, you are subject to health underwriting and insurers may deny you a Medigap policy, or it may cost more. 

If you delay enrolling in Part B because you have group health coverage based on your (or your spouse’s) current employment, your Medigap Open Enrollment Period won’t begin until you sign up for Part B.
Confused? Hopefully not! Understanding Medicare enrollment periods empowers you to make better, more informed choices about your healthcare. If you would like to learn more,  visit Medicare.gov.








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